Dispensing rates for Paxlovid — an oral antiviral treatment for COVID-19 — have increased by more than 130 percent since pharmacists were allowed to prescribe the drug, the Ontario government says.
Pharmacists can prescribe Paxlovid to patients from December 12. Before that date, Ontarians needed a prescription from a doctor or clinical assessment center to access the treatment.
Justin Bates, CEO of the Ontario Pharmacists Association (OPA), said it makes sense for pharmacists to help prescribe Paxlovid because of the short time frame it has to be taken.
The drug works best when taken within five days of the onset of symptoms, officials said. Once received, patients take two doses each day for five days.
“Having this turnkey solution in one pharmacy to be able to assess, prescribe and dispense is really important,” Bates said.
“Just like with minor ailments, it eliminates the need to go to multiple locations and increases timeliness of care and recovery time. So for us, I think it was successful.”
According to the Department of Health, there has been a 131% increase in the dispensing rate of Paxlovid since December 12.
In total, the ministry says more than 101,000 prescriptions were issued in Ontario by pharmacists, doctors and nurse practitioners.
Paxlovid is only available to people at high risk of severe illness or hospitalization as a result of COVID-19.
Although the treatment is relatively easy for patients to take at home, experts say it’s also quite a complex drug with “a huge number of drug interactions”.
“It can be really complicated to prescribe,” Kelly Grindrod, an associate professor in the School of Pharmacy at the University of Waterloo, told CTV News Toronto.
“So it actually makes a lot of sense for pharmacists who focus on having the right drug list and managing it to prescribe because they actually understand how to mitigate things, how to adjust other therapies, what to look for.”
Grindrod says there are dozens of drugs that can interact with Paxlovid, including common pills that manage cholesterol and blood pressure. However, pharmacists understand how these interactions can be managed and can adjust doses accordingly.
“That’s what pharmacists do,” she said.
Just under a month after pharmacists began prescribing the COVID treatment, their responsibilities were expanded to include the ability to prescribe drugs for 13 common illnesses.
The 13 conditions include hay fever, oral thrush, dermatitis, pink eye, menstrual cramps, acid reflux, hemorrhoids, herpes, impetigo, insect bites and hives, tick bites, sprains and strains, and urinary tract infections.
Health Minister Sylvia Jones said at the time that the move would provide Ontarians with more convenience and “free up doctors” to provide care for more complex needs.
As of the first week of January, it is unclear how many pharmacies are actually prescribing these drugs. Bates said he believes a majority of OPA members will provide the service at some point this month; although it may take a little longer for others to scale up the staff and infrastructure needed to do so.
“I believe, based on our anecdotal evidence and in conversations with our members, that the majority will propose this within the next 30 days, if they haven’t already,” he said.
TIME-KEEPING RECIPES
Bates said most pharmacies will use an appointment-based system that will allow patients to book sessions similar to how they would get their flu or COVID-19 shots. This, he said, would allow pharmacies to be properly staffed.
Walk-ins may be accepted at some locations.
CTV News Toronto asked the Ministry of Health how many pharmacies have said they will offer prescription services and was told the “new numbers” will be available sometime next week.
Although the idea of pharmacists being able to prescribe more drugs is new to Ontario, most provinces across Canada already have a similar program in place.
“Ontario is actually a fairway behind the other provinces,” Grindrod said. “Most other provinces have had some variation of minor illness programs for some time. In some places like Saskatchewan, it’s been more than 10 years.”
Grindrod said that before these changes, pharmacists were already dealing with those prescriptions — answering questions patients might have about their illnesses, noting drug interactions and adjusting dosages when necessary.
“The real change here is that pharmacists are actually getting paid for this work that they’ve already been doing.”
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